Osseous manipulation

The native extracellular matrix (ECM) contains a host of matricellular proteins and bioactive factors that regulate cell behavior, and many ECM components have been leveraged to guide cell fate. However, the large size and chemical characteristics of these constituents complicate their incorporation into biomaterials without interfering with material properties, motivating the need for alternative approaches to regulate cellular responses. Mesenchymal stromal cells (MSCs) can promote osseous regeneration in vivo directly or indirectly through multiple means including (1) secretion of proangiogenic and mitogenic factors to initiate formation of a vascular template and recruit host cells into the tissue site or (2) direct differentiation into osteoblasts...

OBJECTIVE: The purpose of this retrospective study was to evaluate the clinical and oncological results of combination treatment of short-term preoperative denosumab (the receptor activator of nuclear factor kappa-B ligand inhibitor) with surgery in unresectable or recurrent cases of giant cell tumor of the bone (GCTB). METHODS: Between 2016 and 2018, 11 eligible patients (1 man, 10 women, mean age 38.1 years) with grade 3 GCTB were treated with a combination of short-term (six doses) preoperative denosumab and surgery in a single institution...

Localized vertical bone defects within the anterior mandibular alveolar ridge frequently pose a unique challenge for functionally and aesthetically pleasing rehabilitation of this area. Causes for significant bone loss in this region may include periodontal disease, postextraction atrophy, trauma, and orthodontic treatment. In the presence of such a defect, ridge augmentation may be obligatory before installation of dental implants. Several surgical procedures, notably bone augmentation techniques, including guided bone regeneration, onlay bone grafting, and interpositional grafts, have been described...

Dental implant-supported prostheses are an established treatment modality for the functional and esthetic rehabilitation of partial and/or complete edentulous patients. One of the most essential factors for successful treatment outcomes stems from preservation of the peri-implant bone. Early peri-implant crestal bone loss has been a common observation, coincides with the time period where most treatment manipulations occur and has been considered as a complex multifactorial event. Microbial leakage at the implant-abutment interface has been associated with inflammatory reactions that may jeopardize peri-implant crestal bone stability...

The diagnosis of femoroacetabular impingement (FAI) syndrome requires that 3 prerequisites are met. Patient symptoms and physical examination must be combined with imaging to appropriately make the diagnosis. Imaging, including plain radiographs, magnetic resonance imaging (MRI), and computed tomography, should be interpreted in the context of a high prevalence of cam and pincer morphology, in addition to labral injury, in the general population. All images routinely obtained in current clinical practice are 2-dimensional representations of complex 3-dimensional processes...

INTRODUCTION:  The short osteotomy was first reported by Blair in 1907 and was later described and characterized by Kater and Paulus in 2013. The technique involves an oblique supra-lingular osteotomy from internal to external, from top to bottom and from back to front. It is designed to divide the ramus into two segments, the joint and the mandibular body, and to ensure minimal valve equivalents. Both osseous valves were maintained in contact by obtaining surface contact proportional to the angle of the osteotomy...

BACKGROUND: Tibial geometry and knee laxity have been identified as risk factors for both noncontact anterior cruciate ligament (ACL) rupture and instability in the setting of ACL insufficiency via clinical studies; yet, their biomechanical relationships with tibiofemoral kinematics during compressive loading are less well understood. The purpose of this study was to identify the relative contributions of sagittal tibial slope, medial tibial eminence volume, and anterior knee laxity to tibiofemoral kinematics with axial compression in both ACL-intact and ACL-sectioned cadaveric knees...

The inner ear is a complex organ containing highly specialised cell types and structures that are critical for sensing sound and movement. In vivo , the inner ear is difficult to study due to the osseous nature of the otic capsule and its encapsulation within an intricate bony labyrinth. As such, mammalian inner ear explants are an invaluable tool for the study and manipulation of the complex intercellular connections, structures, and cell types within this specialised organ. The greatest strength of this technique is that the complete organ of Corti, or peripheral vestibular organs including hair cells, supporting cells and accompanying neurons, is maintained in its in situ form...

PURPOSE: Accurate placement of spinal pedicle screws (PS) is mandatory for good primary segmental stabilization allowing consequent osseous fusion, requiring judgmental experience developed during a long training process. Computer navigation offers permanent visual control during screw manipulation and has been shown to significantly lower the risk of pedicle perforation. This study aims to evaluate whether safety, accuracy, and judgmental skills in screw placement, comparable to an experienced surgeon, can be developed during training using computer navigation...

OBJECTIVE: The purpose of this study was to evaluate the osseous variation of the axis spinous process as it may relate to palpation by clinicians. METHODS: Morphologies of the bifid spinous process in the intact dry axis of 121 Chinese adult were investigated and classified. The angular deflection of the spinous processes, the bifid spinous processes (the bifid portions of the spinous processes), and the length of the bifid spinous processes were observed and measured...

Displaced intra-articular calcaneal fractures represent life-altering injuries. Difficulty obtaining and maintaining calcaneal morphology and the significant risk of wound healing complications with an extensile lateral incision exist. Open reduction with internal fixation as a joint-sparing approach has been studied. Closed manipulation to restore calcaneal morphology, intra-osseous fracture reduction, and rigid locked CALCANAIL fracture nail fixation have recently been applied to Sanders IV fracture patterns...

Although open reduction and internal fixation for treating displaced intra-articular calcaneal fractures remain common, difficulty obtaining and maintaining both calcaneal morphology and subtalar articular surface reduction remain. In addition, open approaches induce a significant risk of wound-healing complications. For this reason, closed manipulation to restore calcaneal morphology, intra-osseous fracture reduction, and rigid locked nail fixation was developed and validated for clinical use. Conversion to an immediate primary or delayed reconstructive subtalar joint arthrodesis using the same instrumentation remains unique to this system...

Lack of standardization of clinically compliant culture protocols of mesenchymal stem cells for re-implantation in humans have hindered clinical progress in the field of tissue regeneration to repair maxillofacial and orthopedic defects. The goal of this study was to establish a clinically relevant osteogenic protocol for collection and expansion of autologous stem cells to be used at Marshall University for re-implantation and repair of maxillofacial and orthopedic conditions. Human bone marrow (hBM) samples were collected from patients undergoing intramedullary nail fixation for closed femoral fractures...

BACKGROUND: Fresh osteochondral allograft transplantation is an appealing option to address a failed cartilage repair surgical procedure, given the ability to treat large lesions and to address the subchondral osseous changes commonly seen in the revision setting. We hypothesized that osteochondral allograft transplantation after failed cartilage repair would result in low failure rates and improved function and that improved graft incorporation on postoperative magnetic resonance imaging (MRI) would correlate with a superior clinical outcome...

For a long time, osteocytes were regarded as passive bystanders of bone metabolism. Bone remodeling was considered to be an interplay between bone forming osteoblasts and bone degrading osteoclasts. However, the dogma of osteocytes as bystanders within the bone has changed fundamentally since the turn of the millenium. Rather than being silent bystanders, osteocytes are the master cells of bone metabolism. To illustrate the central role of osteocytes, we performed a selective literature research in PubMed and Google Scholar using the search terms "osteocyte", "fracture healing", "bone healing", "bone remodeling", "bone metabolism", "sclerostin", "RANKL/OPG", "Wnt signaling pathway" and "FGF23"...

Background: In this prospective safety study, we investigated if the characteristic cytokine expression during bone regeneration is manipulated by the local application of bone morphogenetic protein-7 (BMP-7) in non-union surgery. Therefore, the levels of insulin like growth factor 1 (IGF-1), platelet-derived growth factor AB (PDGF-AB) and transforming growth factor beta (TGF-β) were compared between patients with the gold standard use of autologous bone graft (ABG) and those with additional application of BMP-7 as part of the diamond concept...

The infraorbital nerve (ION) can easily be damaged by orbital trauma and periorbital surgical manipulations, due to its abutment to the orbital floor. Anatomic variability of the ION and surrounding structures has infrequently been documented. The aim of this study is to give precise anatomical knowledge about the ION with surrounding structures, to avoid iatrogenic injury of the ION during periorbital procedures.Forty orbits of 40 skull subjects (20 males and 20 females) were studied to analyze structures around the ION...

BACKGROUND: There is no established treatment for rigid residual deformity of congenital clubfoot (CCF) after walking age. Soft-tissue procedures, osseous procedures, and external fixation have been performed with unpredictable results. We applied the Ponseti method to patients with this condition in order to improve the outcomes of treatment. METHODS: We retrospectively reviewed the cases of 44 patients (68 feet) with congenital clubfoot whose mean age (and standard deviation) at treatment was 4...

OBJECTIVES: Facial Aesthetics, a major consideration in orthodontic diagnosis and treatment planning, may not be judged correctly and completely by simply analyzing dental occlusion or osseous structures. Despite this importance, there is no index to guarantee availability of treatment or prioritize patients based on their soft tissue treatment needs. Individuals having well-aligned teeth but unaesthetic convex profiles do not get included for treatment as per current malocclusion indices...

Osteoradionecrosis is a known complication following radiation therapy, presenting most commonly in the cervical spine as a delayed consequence of radiation that is often necessary in the management of head and neck cancers. In contrast, osteoradionecrosis has rarely been described in the lumbar spine. Here we describe, to our knowledge, the first reported case of lumbar spine osteoradionecrosis, after adjuvant radiation for a primary spinal cord tumor, leading to progressive degenerative scoliosis which required subsequent operative management...